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The Effect of Repeated Education using a Computerized Scoring System for the Proper Use of Inhalation Medicine.

Sung Ken YU ; Sung Im PARK ; So Young PARK ; Jung Kyu PARK ; Sung Eun KIM ; Jung Youp KIM ; Kyeong Cheol SHIN ; Jin Hong CHUNG ; Kwan Ho LEE

Tuberculosis and Respiratory Diseases.2007;63(6):491-496. doi:10.4046/trd.2007.63.6.491

BACKGROUND: The best way of delivering drugs for the treatment of asthma and chronic obstructive pulmonary disease (COPD) is via the inhaled route of administration. However, many patients use inhaler devices incorrectly. To augment the proper use of inhalation medicine and to improve knowledge of the disease and compliance, we have developed a "Computerized Respiratory Service Program" and applied the use of this program to educate patients. METHODS: Prospectively, this study was performed in 164 patients with asthma or COPD prescribed with inhaled medication. When inhalation medication was first prescribed, education using a drug model was conducted two times and thereafter every month. In addition, education using a drug model was conducted and the ability of the patient to use inhalation medicine properly was evaluated. RESULTS: A total of 164 patients participated in the sessions more than two times and received education. Fifty-seven patients participated in three sesions. After the patients received education one time, the ability of these patients to use an inhaler had an average score of 20.6. After the patients received education two times, the average score was 21.9. After the patients received education three times, the average score was 22.3, a further increase. The compliance of using the inhaler was 70.1% at the second session and increased to 81.8% at the third session. CONCLUSION: Feedback education using the "Computerized Respiratory Service Program" will increase the ability of the patient to use an inhaler and consistent education can maintain patient compliance with inhaler use.
Asthma ; Compliance ; Education* ; Humans ; Inhalation* ; Nebulizers and Vaporizers ; Patient Compliance ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive

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The Effect of Corticosteroid in Conservative Treatment of Patients with Hemoptysis.

Jee Suk KWON ; Seung Soo YOO ; Yeh Rim KANG ; Jeong Woo LEE ; Eun Jin KIM ; Seung Ick CHA ; Jae Yong PARK ; Tae Hoon JUNG ; Chang Ho KIM

Tuberculosis and Respiratory Diseases.2007;63(6):486-490. doi:10.4046/trd.2007.63.6.486

BACKGROUND: This study examined the effect of corticosteroids as a short-term treatment for patients with hemoptysis that requires conservative treatment including bed rest, antitussives and antibiotics. METHODS: From February 2005 to August 2006, 78 consecutive patients who visited the emergency room because of hemoptysis were enrolled in the study. Patients with hemoptysis due to lung cancer, active pulmonary tuberculosis, and pneumonia were excluded. The 78 patients were divided randomly into a corticosteroid medication group (n=37) and a control group (n=41). The mean control time of hemoptysis, mean in-hospital days, and complications of treatment were investigated prospectively. RESULTS: For the etiology of hemoptysis, inactive pulmonary tuberculosis alone or its associated complications (bronchiectasis and/or aspergilloma) were the most common causes (51%); bronchiectasis alone and bronchitis were the next most common causative diseases (15%, respectively). The patients' characteristics and symptoms in the corticosteroid medication and control groups were similar. The steroid medication group showed a significantly lower mean control time of hemoptysis than the control group (4.0+/-2.7 days, 6.1+/-4.8 days, respectively) (p=0.022) and had a lower mean number of in-hospital days (5.8+/-3.4 days, 7.9+/-4.8 days, respectively) (p=0.036). There were no significant complications, such as hospital-acquired pneumonia or gastrointestinal bleeding, related to the use of corticosteroids. CONCLUSION: The use of corticosteroids as a conservative treatment for hemoptysis due to bronchitis, bronchiectasis, inactive pulmonary tuberculosis and its related complications safely reduces the control time of hemoptysis as well as the number of in-hospital days.
Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Antitussive Agents ; Bed Rest ; Bronchiectasis ; Bronchitis ; Emergency Service, Hospital ; Hemoptysis* ; Hemorrhage ; Humans ; Lung Neoplasms ; Pneumonia ; Prospective Studies ; Tuberculosis, Pulmonary

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Symptom Questionnaire and Laboratory Findings in Subjects with Airflow Limitation: a Nation-wide Survey.

Yong Il HWANG ; Young Chul KIM ; Jae Ho LEE ; Min Jong KANG ; Dong Gyu KIM ; Soo Ock KIM ; Tae Won JANG ; Min Ki LEE ; Youngsoo AHN ; Jee Hong YOO ; Ki Suck JUNG

Tuberculosis and Respiratory Diseases.2007;63(6):480-485. doi:10.4046/trd.2007.63.6.480

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation that is not fully reversible. COPD has systemic effects, such as skeletal muscle dysfunction and abnormal weight loss. It also has been suggested that COPD is related to other chronic disease, such as cardiovascular disease, osteoporosis, and anemia. The aim of this study was to evaluate a symptom questionnaire and laboratory findings in subjects with air flow limitation. METHODS: We evaluated a symptom questionnaire and laboratory findings in subjects with airflow limitation detected by spirometry in conjunction with the Second Korean National Health and Nutrition Examination Survey. A total of 9,243 adults over the age of 18 were recruited. Among the adults, we finally analyzed 2,217 subjects who met the acceptability and repeatability criteria of spirometry, showed normal findings on chest radiography, and were older than 40 years of age. RESULTS: There were 288 subjects with airflow limitation as determined by spirometry. The frequency of respiratory symptoms such as cough, sputum and wheezing were significantly higher in subjects with airflow limitation (p<0.01). Hemoglobin and hematocrit levels were higher in subjects with airflow limitation (hemoglobin level 13.98 mg/dL vs. 13.62 mg/dL, hematocrit 42.10% vs. 40.89%; p<0.01). The HDL cholesterol level was lower in subjects with airflow limitation (44.95 mg/dL vs. 45.60 mg/dL; p<0.01). There was no significant difference in the total cholesterol, triglyceride, blood urea nitrogen, creatinine, and fasting glucose levels. CONCLUSION: In subjects with airflow limitation, prevalence of respiratory symptoms was higher than in normal spirometry subjects and the levels of hemoglobin and the hematocrit were higher. The HDL cholesterol level was lower in subjects with airflow limitation.
Adult ; Anemia ; Blood Urea Nitrogen ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Chronic Disease ; Cough ; Creatinine ; Fasting ; Glucose ; Hematocrit ; Humans ; Muscle, Skeletal ; Nutrition Surveys ; Osteoporosis ; Prevalence ; Pulmonary Disease, Chronic Obstructive ; Surveys and Questionnaires* ; Radiography ; Respiratory Sounds ; Spirometry ; Sputum ; Thorax ; Triglycerides ; Weight Loss

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Cellular and Molecular Pathophysiology of Idiopathic Pulmonary Arterial Hypertension.

Seung Won RA ; Sang Do LEE

Tuberculosis and Respiratory Diseases.2007;63(6):475-479. doi:10.4046/trd.2007.63.6.475

No abstract available.
Hypertension*

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Roentgenogram of the Issue: Osteolytic Bone Lesion of the Rib.

Ju Hyun CHA ; Jung Hyun CHANG ; Sung Min CHO ; Hyae Young KIM ; Woon Sub HAN ; Kwang Ho KIM

Tuberculosis and Respiratory Diseases.1997;44(2):430-434. doi:10.4046/trd.1997.44.2.430

A 29-year-old male patient was admitted due to subacute onset of right chest pain. He had no history of trauma, chest surgery or other medical disease. Chest roentgenogram showed an expansile, radiolucent lesion on the posterior segment of right seventh rib. Computed tomogram of the chest also showed lytic expansile mass with septation. He took an en-bloc resection of the involved rib. Pathologically there were multiple cystic spaces, filled with blood and collagenofibrous tissue proliferation and locally areas of new bone formation and giant cells of osteoclastic type, which was compatible with aneurysmal bone cyst. We report a case of aneurysmal bone cyst of the rib with a brief review of literature.
Adult ; Aneurysm ; Bone Cysts ; Chest Pain ; Giant Cells ; Humans ; Male ; Osteoclasts ; Osteogenesis ; Ribs* ; Thorax

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A Case of Thymic Carcinoid Tumor.

Seong Min KIM ; Jeong Mee KIM ; Yeon Soo KIM ; Byeong Cheol KIM ; Jang Won SOHN ; Suck Chul YANG ; Ho Joo YOON ; Dong Ho SHIN ; Sung Soo PARK ; Jung Hee LEE ; Wan Seop KIM ; Moon Hyang PARK ; Yo Won CHOI

Tuberculosis and Respiratory Diseases.1997;44(2):425-429. doi:10.4046/trd.1997.44.2.425

Until 1972, many carcinoid tumors of the thymus were not recognized as distinct lesions and were mistakenly labeled as variants of thymomas. Thymic carcinoid tumors are unusual neoplasms that show different morphological, functional, and behavioral characteristics than those of thymomas. We report a case of a 65-year-old woman with thymic carcinoid tumor. The cinicopathological findings are discussed with a review of the literature.
Aged ; Carcinoid Tumor* ; Female ; Humans ; Thymoma ; Thymus Gland

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A Case of Primary Pulmonary Leiomyosarcoma.

Han Ki HONG ; Jung Min BAIK ; Young Bae OH ; Hee Yeon KIM ; Chan Joo LEE ; Sang Moo LEE ; Man Sil BAK ; Eun Kyoung KIM

Tuberculosis and Respiratory Diseases.1997;44(2):419-424. doi:10.4046/trd.1997.44.2.419

Primary Pulmonary leiomyosarcomas are rare tumors. These tumors may arise at any level of the lung in which smooth muscle fibers are found. The highest incidence of sarcoma is during the fourth decade whereas for bronchogenic carcinoma the maximum incidence is during the sixth and seventh decades. Leiomyosarcomas are aggressive and progressive. Treatment is mainly surgical. The chemotherapy is ineffective and the effectiveness of radiotherapy depends on the total dose of irradiation. Prognosis and significant survival rate are related to the size of the lesion. We report one patient with primary pulmonary leiomyosarcoma involving the right lower lung.
Carcinoma, Bronchogenic ; Drug Therapy ; Humans ; Incidence ; Leiomyosarcoma* ; Lung ; Muscle, Smooth ; Prognosis ; Radiotherapy ; Sarcoma ; Survival Rate

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The Effect of Corticosteroid on the Treatment of Endobronchial Tuberculosis.

Eun Kyung MO ; Ho Joong KIM ; Jung Eun CHOI ; Dong Gyn KIM ; Myung Jae PARK ; In Gyu HYUN ; Myung Koo LEE ; Ki Suck JUNG

Tuberculosis and Respiratory Diseases.1997;44(2):409-418. doi:10.4046/trd.1997.44.2.409

OBJECTIVE: Appropriate antituberculosis chemotherapy may not prevent occurrence or progression of tracheobronchial stenosis and obstruction in the patients with endobronchial tuberculosis. The effect of corticosteroid treatment combined with antituberculosis chemotherapy was inconclusive. We evaluated prospectively the effect of corticosteroid treatment. METHODS: We diagnosed endobronchial tuberculosis by bronchoscopic examination and bronchial biopsy in the patients of tuberculosis within one month of antituberculosis chemotherapy. After randomization, we prescribed isoniazid, rifampin, ethambutol, and pyrazinamide with or without prednisolone 40 mg for 4 weeks. We carried out bronchoscopy in second month and ninth month of treatment. RESULTS: Edematous endobronchial tuberculosis showed significant improvement of bronchial stenosis after corticosteroid treatment(p<0.05). Corticosteroid treatment did not have advantage of improvement of bronchial stenosis in the patients with infiltrative endobronchial tuberculosis. CONCLUSION: Corticosteroid is effective in the treatment of bronchial stenosis when endobronchial tuberculosis is edematous type, in the early period of antituberculosis chemotherapy.
Biopsy ; Bronchoscopy ; Constriction, Pathologic ; Drug Therapy ; Ethambutol ; Humans ; Isoniazid ; Prednisolone ; Prospective Studies ; Pyrazinamide ; Random Allocation ; Rifampin ; Tuberculosis*

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Clinical Manifestations of 15 Cases of Pulmonary Sequestration.

Kwang Joo PARK ; Eun Sook KIM ; Hyung Jung KIM ; Joon CHANG ; Chul Min AHN ; Sung Kyu KIM ; Won Young LEE ; Sang Jin KIM ; Doo Yun LEE

Tuberculosis and Respiratory Diseases.1997;44(2):401-408. doi:10.4046/trd.1997.44.2.401

BACKGROUND: Pulmonary sequestration is a rare congenital malformation, which is manifested by formation of nonfunctioning lung tissue lacking normal communication with the tracheobronchial tree. The preoperative diagnostic rate has been relatively low, and without consideration of pulmonary sequestration, unexpected bleeding from aberrant vessels may be a serious problem during the operation. The purpose of our study is to describe the clinical features of pulmonary sequestration based on a review of 15 cases treated by operation. METHOD: Fifteen patients with pulmonary sequestration who had undergone surgical treatment from 1991 through May 1996 at Yongdong Severance Hospital and Severance Hospital were reviewed retrospectively. RESULTS: The mean age of the patients was 22.5 years (range 5-57), and male to female ratio was 9:6. Clinical presentations varied from recurrent respiratory infections such as fever, cough, and sputum or chest pain to no symptom. The chest simple X-rays showed multicystic shadow(10/15) and solid mass-like shadow(5/15). The chest CT scans, done in twelve cases, showed multicystic lesion with or without lung infiltration(8/l2), solid mass-like lesion(4/12), The chest MRIs, done in three cases, revealed the aberrant arteries originating from descending aorta(2/3). Aortograms, done in four cases, showed the aberrant arteries originating from descending thoracic aorta(2/4), abdominal aorta(1/4), and intercostal artery(1/4). and the venous returns were via the pulmonary veins. Pulmonary sequestration was considered preoperatively in six patients of fifteen. Other preliminary diagnosis were lung tumor(3/15), lung abscess(2/15), bronchiectasis(2/15), and mediastinal tumor(2/15). In the operative findings, twelve cases were of intralobar type and three cases of extralobar type. The left lower lobe was most often affected(9/15) and one extralobar sequestration was in the pericardium. The aberrant arteries originated from descending thoracic aorta(6/15), abdominal aorta(1/15), internal thoracic arteries(2/15), intercostal artery(1/15), pericardiophrenic artery( 1/15), but in four cases, the origins could not be defined. There was no mortality or complication postoperatively. CONCLUSION: In our study, preoperative diagnostic rate was relatively low, and clinical features were similar to previous reports. Preoperative vigorous diagnostic approach including aortography is strongly advocated not only for its diagnostic value, but also for accurate localization of the aberrant vessels, which is major concern to surgical procedure.
Angiography ; Aortography ; Arteries ; Bronchopulmonary Sequestration* ; Chest Pain ; Cough ; Diagnosis ; Female ; Fever ; Hemorrhage ; Humans ; Lung ; Magnetic Resonance Imaging ; Male ; Mortality ; Pericardium ; Pulmonary Veins ; Respiratory Tract Infections ; Retrospective Studies ; Sputum ; Thorax ; Tomography, X-Ray Computed

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Efficacy and Safety of Early Bronchoscopy in Patients with Hemoptysis.

Ho Cheol KIM ; Eun Mee CHEON ; Man Pyo CHUNG ; Hojoong KIM ; Dong Chull CHOI ; O Jung KWON ; Chong H RHEE ; Yong Chol HAN

Tuberculosis and Respiratory Diseases.1997;44(2):391-400. doi:10.4046/trd.1997.44.2.391

BACKGROUND: Bronchoscopy is an essential procedure for identifying the bleeding site and evaluating cause of hemoptysis. However, it is controversial regarding to the timing of bronchoscopy in patients with hemoptysis. Early bronchoscopy, which was performed during hemoptysis or with 48hour after cessation of bleeding, was better for identifying the site of bleeding compared with delayed bronchoscopy, which was performed 48 hours after cessation of bleeding. The diagnostic yield of identifying the bleeding site by bronchoscopy was variable in reported literature and the safety of early bronchoscopy was not mentioned in previous literature. Therefore, we evaluated the efficacy and safety of early bronchoscopy in patients with hemoptysis. METHOD: From October 1994 to August 1996 in Samsung Medical Center, bronchoscopy was performed in patients with hemoptysis. Early bronchoscopy was performed prospectively during hemoptysis or within 48 hours after cessation of bleeding from May 1995 to August 1996. Delayed bronchoscopy group included patients who did not recieved early bronchoscopy at the same period or in whom bronchoscopy was performed 48 hour after cessation of bleeding from October 1994 to May 1995. RESULTS: Early bronchoscopy group was performed 73 times in 71 patients. Delayed bronchoscopy was performed in 57 times in 55 patients. There was no difference as to amount and underlying cause of hemoptysis between both groups. Indentification of bleeding site by visualizing active bleeding was significantly higher in early bronchoscopy(38.3%) than delayed bronchoscopy group (8.7%) (p<0.05). Indentification of bleeding site by bleeding after clot removal was 8 in early and 10 in delayed bronchoscopy. Indentification of bleeding site by visualizing active bleeding and bleeding after clot removal was 36 in early and 15 patients in delayed bronchoscopy(p>0.05). Causes of hemoptysis was found in 18 patients in early and 16 patients in delayed bronchoscopy group. patients who had early bronchoscopy underwent surgery. We diagnosed the site of bleeding in 4 patients preoperatively. In 3 patients we made a treatment plan promptly right after bronchoscopy. Among early bronchoscopy group, bleeding over 100cc during bronchoscopy occurred in 2 patients. In early bronchoscopy group there was no other major complication during bronchoscopy. CONCLUSION: In patients with hemoptysis, early bronchoscopy which performed within 48 hours after cessation of bleeding was more effective procedure for indentifying the bleeding site than delayed bronchoscopy which was performed after 48 hour cessation of bleeding.
Bronchoscopy* ; Hemoptysis* ; Hemorrhage ; Humans ; Prospective Studies

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